Certificate of Conformity

Consumer Product Safety Improvement Act of 2008

Section 14(g) of the Consumer Product Safety Act, 15 U.S.C. § 2063(g)requires manufacturers, importers, and private labelers (foreign & domestic) to certify that all products manufactured on or after November 12, 2008, are compliant with all applicable standards, rules, and bans enforced by the CPSC.

Compliance shall be evidence by a declaration or certificate of conformity. This certificate is not required to be signed; issuance of the certificate satisfies the requirements of the Consumer Product Safety Act.

This certification MUST be provided in English and based on a test of each product or a reasonable testing program.

Item 1: Identification of the product covered by this certificate.
Product Description
Cinmar Item No.
Vendor Item No.
Container No.
Cinmar Purchase Order
Item 2: Citation to each CPSC product safety regulation to which this product is being certified.
PLEASE PLACE AN “X” IN THE APPROPRIATE BOX and Include the SPECIFIC section(s) of the acts where compliance is being declared and note any claimed exemptions to the acts here as well
Consumer Product Safety Act / Federal Hazardous Substances Act / Flammable Fabrics Act
CPSA Section(s) / FHSA Section(s) / FFA Section(s)
Poison Prevention Packaging Act / Refrigerator Safety Act / Children’s Gasoline Burn Prevention Act
PPPA Section(s) / RSA Section(s) / CGBPA Section(s)
Virginia Graham Baker Pool and Spa Safety Act / Not subject to any CPSC Standards, Bans, Rules or Regulations
VGBPSSA Section(s)
ATTENTION: IF THE ITEM IS SUBJECT TO ANY OF THE ABOVE LISTED ACTS, THE BELOW INFORMATION MUST BE COMPLETED
Item 3: Identification of the US importer or domestic manufacturer certifying compliance of the product:
Name
Full Mailing Address
Phone #
Item 4: Contact information for the individual maintaining records of test results:
Name
Full Mailing Address
Phone #
Email address
Item 5: Date and place where this product was manufactured:
Date(s) of Manufacture (MM/YYYY)
Full Mailing Address including street, city, country
Item 6: Date and place where this product was tested for compliance with the regulation(s) cited above.
Date(s) of Testing (MM/YYYY)
Testing Location including city, country or administrative region
Item 9: Identification of any third-party laboratory on whose testing the certificate depends.
Laboratory Name
Laboratory Full Mailing Address
Laboratory Phone #

General Instructions for completing the Certificate of Conformity

Item 1: Describe the product covered by this certification in enough detail to match the certificate to each product it covers and no others.

Item 2: The certificate must identify separately each applicable rule, ban, standard or regulation under the Acts administered by the Commission that is applicable to the product. The section reference should be identified in the text field, as well as any “exemptions” to the regulation being claimed.

Act Title / Section References (for illustrative purposes only, may not be an exhaustive list)
Consumer Product Safety Act (CPSA) / 16CFR1201 – Architectural Glazing Materials
16CFR1202 – Matchbooks
16CFR1203 – Bicycle Helmets
16CFR1204 – Antennas
16CFR1205 – Lawnmowers
16CFR1207 – Swimming Pool Slides
16CFR1209 – Interim Standard for Cellulose Insulation
16CFR1210 – Cigarette Lighters
16CFR1211 – Garage Door Openers
16CFR1212 – Multi-purpose Lighters
16CFR1213 – Entrapment in Bunk Beds
16CFR1301 – Refuse Bins
16CFR1302 – Flammable Contact Adhesives
16CFR1303 – Lead-Containing Paint
16CFR1304 – Consumer Patching Compounds
16CFR1305 – Artificial Emberizing Materials
16CFR1306 – Lawn Darts
16CFR1401 – Self-Pressurized Consumer Products
16CFR1402 – CB Base Station/TV Antennas
16CFR1404 – Cellulose Insulation
16CFR1406 – Coal and Wood Burning Appliances
Federal Hazardous Substances Act (FHSA) / 16CFR1500 – Hazardous Substances / Toys and Other Articles Intended for Use by Children
16CFR1501 – Small Parts (Children <3 years)
16CFR1505 – Electrically Operated Toys and Other Electrically Operated Articles Intended for Use by Children
16CFR1507 – Fireworks Devices
16CFR1508/1509 – Baby Cribs
16CFR1510 – Rattles
16CFR1511 – Pacifiers
16CFR1512 – Bicycles
16CFR1513 – Bunk Beds
Flammable Fabrics Act (FFA) / 16CFR1610 – Clothing Textiles / Wearing Apparel
16CFR1611 – Vinyl Plastic Film
16CFR1615/1616 – Children’s Sleepwear
16CFR1630/1631 – Carpets and Rugs
16CFR1632 – Mattresses and Mattress Pads
Poison Prevention Packaging Act (PPPA) / 16CFR1700
Refrigerator Safety Act (RSA) / 16CFR1750

Item 3: Provide the name, full mailing address, and telephone number of the domestic manufacturer or US importer of the product.

Item 4: Provide the name, full mailing address, e-mail address and telephone number of the person maintaining test records in support of the certification.

Item 5: Provide the date(s) when the product was manufactured by at least month and year. For the place of manufacture, if different from the manufacturer’s address in item 3, provide at least the city and country or administrative region, of the place where the product was finally manufactured or assembled.

If the same manufacturer operates more than one location in the same city, provide the street address of the factory.

Item 6:Provide the date(s) of the tests or test report(s) on which certification is being based and the location(s) of the testing.

Item 7: If a third-party laboratory tested the product or conducted a testing program on which the certification is based, provide the name, full mailing address and telephone number of the laboratory.